aDivision of Surgical & Interventional Sciences, University College London bDepartment of Urology, University College London Hospitals Trust, London, UK.
Curr Opin Urol. 2014 May;24(3):280-7. doi: 10.1097/MOU.0000000000000040.
The role of MRI in active surveillance to date has been in assessing men with low or intermediate-risk disease to identify those men harbouring higher risk disease undersampled at standard biopsy. MRI as a tool for reassessing men over the surveillance period, as an alternative to repeat standard biopsies, is also of interest.
Multiple studies suggest that MRI early in active surveillance can identify men whose prostate cancer was undersampled at initial biopsy, and MRI-targeted biopsies can be offered. There are a small number of centres now using MRI in the routine follow-up of men on active surveillance. The presence of a lesion on MRI indicates that a man is at higher likelihood of radiological progression than men with a negative MRI at diagnosis. These findings need to be validated in longer-term studies with predefined criteria for radiological significance and radiological progression.
MRI is useful in the identification of men with higher-risk prostate cancer prior to commencement of a formal active surveillance programme. It is also of use in following up men on active surveillance, as a way to detect change in tumour over time.
迄今为止，MRI 在主动监测中的作用一直在于评估低危或中危疾病的男性，以识别那些在标准活检中被抽样检查的高危疾病男性。MRI 作为一种在监测期间重新评估男性的工具，作为重复标准活检的替代方法，也引起了人们的兴趣。
多项研究表明，主动监测早期的 MRI 可以识别出在初始活检中被抽样检查的前列腺癌患者，并可以提供 MRI 靶向活检。现在有少数中心在主动监测男性的常规随访中使用 MRI。MRI 上存在病变表明，与诊断时 MRI 阴性的男性相比，该男性发生影像学进展的可能性更高。这些发现需要在具有影像学意义和影像学进展预定义标准的长期研究中得到验证。
MRI 可用于在正式开始主动监测计划之前识别高危前列腺癌男性。它也可用于主动监测男性，作为随时间检测肿瘤变化的一种方法。
